JP5000233B2 - 単一通路における胃縮小術を内視鏡により行なうための方法および装置 - Google Patents
単一通路における胃縮小術を内視鏡により行なうための方法および装置 Download PDFInfo
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Description
〔発明の分野〕
本発明は胃縮小術に関連している。特に、本発明は、単一通路における胃縮小術を内視鏡により行なうための方法および装置に関連している。
病的肥満は深刻な症状である。実際に、病的肥満は、米国、ならびにその他の組において非常に広がっており、この傾向は悪化の方向に向かっているように思われる。病的肥満に付随する合併症は、平均寿命を著しく縮める、高血圧、糖尿病、冠動脈病、発作、うっ血性心不全、複数の整形外科的な問題、および肺動脈弁閉鎖不全、を含む。このことを考慮して、また、当業界の熟練者が確かに理解するように、病的肥満に伴う金銭および身体的なコストは相当である。実際に、肥満に関連する費用は、米国だけでも、1000億ドルを超えていると、推定されている。
それゆえ、本発明の目的は、胃壁の中に複数のファスナーの安定した取り付けを行なう胃縮小装置を提供することであり、これらのファスナーは個人の胃の有効な大きさの縮小を可能にする様式で柔軟な部材により連結されている。この装置は、近位側端部および遠位側端部を有するアプリケータ・ヘッド、を含んでいる。この胃縮小装置のアプリケータ・ヘッドは、組織を受容するような、形状および寸法、に作られているキャビティ、を含んでいる。また、ファスナー取付機構が、上記キャビティの中に引き込まれる組織に接触するために、そのキャビティの中に位置決めされており、このファスナー取付機構は複数のファスナーを含んでいる。
本発明の詳細な実施形態がここに開示されている。しかしながら、これらの開示されている実施形態が本発明の単なる例示であって、これらは種々の形態で実施可能であるということ、が理解されるべきである。それゆえ、ここに開示されている詳細は、限定として解釈されるべきではなく、単に、特許請求の範囲における各請求項のための基礎として、さらに、本発明を作成および/または使用する方法を、当業者に教示するための基礎として、解釈されるべきである。
(1)胃壁内への複数のファスナーの安定した取り付けを行なう胃縮小装置であって、前記ファスナーが、個人の胃の有効な大きさの縮小を可能にするように、柔軟な部材により連結されている、胃縮小装置において、
前記胃縮小装置のアプリケータ・ヘッドであって、近位側端部と遠位側端部とを有し、組織を受容するような、形状および寸法、に作られているキャビティを含む、アプリケータ・ヘッドと、
ファスナー取付機構であって、前記キャビティの中に引き込まれる組織に接触するために前記キャビティの中に配置されていて、少なくとも1個のファスナーを含んでいる、ファスナー取付機構と、
を備えている、胃縮小装置。
(2)実施態様1に記載の胃縮小装置において、
前記近位側端部は、胃鏡の遠位側端部に安定して取り付けられるような、形状および寸法、に作られている、胃縮小装置。
(3)実施態様1に記載の胃縮小装置において、
前記キャビティは、前記組織が前記キャビティの中に引き込まれている状態で、ファスナーを前記組織に固定するために、組織を受容するための広い開口部を備えている実質的にベルの形に作られている、胃縮小装置。
(4)実施態様1に記載の胃縮小装置において、
前記ファスナー取付機構は、電気活性なポリマーにより構成されている発射機構、を含んでいる、胃縮小装置。
(5)実施態様1に記載の胃縮小装置において、
前記ファスナー取付機構は、フックおよびアンビル、を含んでいる、胃縮小装置。
前記フックは、第1の端部と第2の端部とを有しており、前記フックの前記第1の端部は、前記ファスナー取付機構により支持されている最上部のファスナーをつかみ、そして、前記ファスナーを前記アンビルに向かって引くための、形状および寸法に作られており、前記ファスナーを前記アンビルに向かって引くことにより、前記キャビティの中に引き込まれている前記組織に前記ファスナーを連結させるような形態で前記ファスナーを閉じる、胃縮小装置。
(7)実施態様6に記載の胃縮小装置において、
前記フックの前記第2の端部は、発射機構に連結されている、胃縮小装置。
(8)実施態様7に記載の胃縮小装置において、
前記発射機構は、前記フックまで延在して、このフックを操作可能にする、ケーブル、バー、またはロッド、を含んでいる、胃縮小装置。
(9)実施態様7に記載の胃縮小装置において、
前記発射機構は、制御された様式で前記フックを近位側に引き込む機構、をさらに含んでいる、胃縮小装置。
(10)実施態様1に記載の胃縮小装置において、
前記キャビティにより定められている内部空間は、真空配管(vacuum line)に流体連通している、胃縮小装置。
前記装置は、胃鏡の面に沿って下降する細長い軸、を含んでおり、前記軸は、近位側端部と遠位側端部とを有しており、前記近位側端部は、前記ファスナー取付機構の制御機構へのアクセス手段を含んでおり、前記アプリケータ・ヘッドは、前記細長い軸の前記遠位側端部に固定されている、胃縮小装置。
(12)実施態様11に記載の胃縮小装置において、
前記細長い軸は、選択的に固定されたトラックにより構成されている、胃縮小装置。
(13)実施態様12に記載の胃縮小装置において、
前記トラックは、共通のケーブルに配置されている複数の連結部材により、構成されている、胃縮小装置。
(14)実施態様13に記載の胃縮小装置において、
前記連結部材は、互いにゆるやかに連結されており、かつ、前記トラックの前記遠位側端部および前記近位側端部の間に延在している引張ケーブルを介して制御される、胃縮小装置。
(15)実施態様13に記載の胃縮小装置において、
前記トラックは、前記トラックとハンドルとの間の旋回式の連結により、回転可能である、胃縮小装置。
前記複数の連結部材は、各嵌め合わせ端部に沿う係止面、を有している、胃縮小装置。
(17)実施態様1に記載の胃縮小装置において、
前記ファスナー取付機構は、ファスナー・プレスとアンビルとを含んでおり、前記ファスナー・プレスは、ファスナーを受容して、前記ファスナーを移動して前記アンビルに接触させる、胃縮小装置。
(18)実施態様17に記載の胃縮小装置において、
前記ファスナー取付機構は、後退位置と発射位置との間において、前記ファスナー・プレスを移動させるための連結組立体、をさらに含んでいる、胃縮小装置。
(19)胃縮小術のための方法において、
胃の中に、胃縮小装置を挿入する工程であって、前記胃縮小装置は、近位側端部と遠位側端部とを有するアプリケータ・ヘッド、を含んでおり、前記胃縮小装置の前記アプリケータ・ヘッドは、組織を受容するための形状および寸法に作られているキャビティ、を含んでおり、前記キャビティの中に引き込まれた組織に接触するために、ファスナー取付機構が前記キャビティの中に配置されており、前記ファスナー取付機構が複数のファスナーを含んでいる、工程と、
前記キャビティの開口部を、胃壁の所定の部分に近接するように、位置決めする工程と、
真空を前記キャビティの中に形成して、前記胃壁の所定の組織を、前記キャビティの中に引き込む工程と、
前記胃の組織の中に前記ファスナーを固定するように、前記ファスナー取付機構を作動する工程と、
を含む、方法。
(20)実施態様19に記載の方法において、
前記方法は、さまざまな所定の胃壁の場所において、繰り返される、方法。
前記ファスナーは、胃に沿って垂直に供給される、方法。
(22)実施態様21に記載の方法において、
前記ファスナーは、胃に沿って垂直に供給されて、ある縫合パタンを最終的に形成するために必要なファスナー配列を形成する、方法。
(23)実施態様19に記載の方法において、
前記ファスナーは、胃の前壁および後壁の間を交互に行き来しながら、胃壁に供給される、方法。
(24)実施態様19に記載の方法において、
柔軟な部材が前記ファスナーに予め通される、方法。
(25)実施態様24に記載の方法において、
前記柔軟な部材が、胃の中にステッチ・パタンを形成するように、通されている、方法。
前記柔軟な部材は、ほぼ垂直な方向に、胃の中にステッチ・パタンを形成するように通されて、胃の中において遠位側および近位側に延在している、方法。
Claims (7)
- 胃壁内への複数のファスナーの安定した取り付けを行なう胃縮小装置であって、前記ファスナーが、個人の胃の有効な大きさの縮小を可能にするように、柔軟な部材により連結されている、胃縮小装置において、
前記胃縮小装置のアプリケータ・ヘッドであって、近位側端部と遠位側端部とを有し、組織を受容するような、形状および寸法、に作られているキャビティを含み、該キャビティにより定められている内部空間は、前記キャビティの中に組織を引き込むために使用される真空配管に流体流通している、アプリケータ・ヘッドと、
ファスナー取付機構であって、前記キャビティの中に引き込まれる組織に接触するために前記キャビティの中に配置されていて、複数のファスナーを含んでいる、ファスナー取付機構と、
を備えており、
前記ファスナー取付機構は、フックおよびアンビル、を含んでおり、
前記フックは、第1の端部と第2の端部とを有しており、前記フックの前記第1の端部は、前記ファスナー取付機構により支持されている最上部のファスナーをつかみ、そして、前記ファスナーを前記アンビルに向かって引くための、形状および寸法に作られており、前記ファスナーを前記アンビルに向かって引くことにより、前記キャビティの中に引き込まれている前記組織に前記ファスナーを連結させるような形態で前記ファスナーを閉じる、胃縮小装置。 - 請求項1に記載の胃縮小装置において、
前記近位側端部は、胃鏡の遠位側端部に安定して取り付けられるような、形状および寸法、に作られている、胃縮小装置。 - 請求項1に記載の胃縮小装置において、
前記キャビティは、前記組織が前記キャビティの中に引き込まれている状態で、ファスナーを前記組織に固定するために、組織を受容するための広い開口部を備えている実質的にベルの形に作られている、胃縮小装置。 - 請求項1に記載の胃縮小装置において、
前記ファスナー取付機構は、電気活性なポリマーにより構成されている発射機構、を含んでいる、胃縮小装置。 - 請求項1に記載の胃縮小装置において、
前記フックの第2の端部は、発射機構に連結されている、胃縮小装置。 - 請求項5に記載の胃縮小装置において、
前記発射機構は、前記フックまで延在して、このフックを操作可能にする、ケーブル、バー、またはロッド、を含んでいる、胃縮小装置。 - 請求項5に記載の胃縮小装置において、
前記発射機構は、制御された状態で前記フックを近位側に引き込む機構、をさらに含んでいる、胃縮小装置。
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US11/206,297 US7771440B2 (en) | 2005-08-18 | 2005-08-18 | Method and apparatus for endoscopically performing gastric reduction surgery in a single pass |
US11/206,297 | 2005-08-18 |
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JP2005296412A (ja) * | 2004-04-13 | 2005-10-27 | Olympus Corp | 内視鏡治療装置 |
US7147138B2 (en) * | 2004-07-28 | 2006-12-12 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having an electroactive polymer actuated buttress deployment mechanism |
US7857183B2 (en) * | 2004-07-28 | 2010-12-28 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating an electrically actuated articulation mechanism |
US20060025812A1 (en) * | 2004-07-28 | 2006-02-02 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating an electrically actuated pivoting articulation mechanism |
US7143925B2 (en) * | 2004-07-28 | 2006-12-05 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating EAP blocking lockout mechanism |
JP4302602B2 (ja) * | 2004-09-24 | 2009-07-29 | オリンパス株式会社 | 内視鏡用処置具及び内視鏡処置システム並びに支持アダプタ |
US7438208B2 (en) * | 2005-01-25 | 2008-10-21 | Entrigue Surgical, Inc. | Septal stapler apparatus |
-
2005
- 2005-08-18 US US11/206,297 patent/US7771440B2/en not_active Expired - Fee Related
-
2006
- 2006-08-08 AU AU2006203408A patent/AU2006203408A1/en not_active Abandoned
- 2006-08-17 EP EP06254311A patent/EP1754444A3/en not_active Withdrawn
- 2006-08-17 JP JP2006222591A patent/JP5000233B2/ja not_active Expired - Fee Related
- 2006-08-17 CA CA002556304A patent/CA2556304A1/en not_active Abandoned
- 2006-08-18 BR BRPI0603381-4A patent/BRPI0603381A/pt not_active IP Right Cessation
- 2006-08-18 CN CN2006101159237A patent/CN1931102B/zh not_active Expired - Fee Related
-
2010
- 2010-02-03 US US12/699,077 patent/US20100137885A1/en not_active Abandoned
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2012
- 2012-01-04 US US13/343,035 patent/US20120118935A1/en not_active Abandoned
Also Published As
Publication number | Publication date |
---|---|
CA2556304A1 (en) | 2007-02-18 |
EP1754444A2 (en) | 2007-02-21 |
CN1931102B (zh) | 2012-01-25 |
US7771440B2 (en) | 2010-08-10 |
AU2006203408A1 (en) | 2007-03-08 |
US20120118935A1 (en) | 2012-05-17 |
JP2007050261A (ja) | 2007-03-01 |
US20070043384A1 (en) | 2007-02-22 |
CN1931102A (zh) | 2007-03-21 |
US20100137885A1 (en) | 2010-06-03 |
EP1754444A3 (en) | 2009-04-22 |
BRPI0603381A (pt) | 2007-09-04 |
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